Prevalence of root caries among elders living in residential homes of Bengaluru city, India

N. S, Singla N, Singhal DK, Singla R. A Cross-Sectional Study to Assess Diabetes as a Risk Factor for Root Caries Amongst the Elderly Population in Udupi District, Karnataka State, India

Objectives

To compare the prevalence of root surface carious lesions among the nondiabetic and diabetic elderly population and its association with various risk factors.

Methods

An observational analytical cross-sectional study was conducted among 800 elderly participants, 431 males and 369 females, aged 50 years and above, with a minimum of ten teeth present, with 400 being diabetic and 400 nondiabetic from the various hospitals of the Udupi district. Demographics, socioeconomic status, oral hygiene practices, oral abusive habits, and history of type 2 diabetes were collected using an interviewer-administered questionnaire followed by an intraoral examination to assess root caries. The primary outcome measure was the presence of any carious or filled root surface. Binary logistic regression univariate analysis was done for all the predictor variables, and those with significant associations were further analyzed by multivariate analysis with the enter method in a single-step model. An appropriate nomogram was designed for risk prediction.

Results

Overall, the root caries prevalence was 37.3%, and the mean root caries index was 14.28%. The prevalence of root caries was 46% in people with diabetes and 28.5% in nondiabetics. Participants with type 2 diabetes, less education, low socioeconomic status, and using finger cleaning had a significantly higher risk of developing root caries. Additionally, those who used removable partial dentures (RPDs) were found to be 4.65 times more likely to have root caries than those who did not use RPDs.

Conclusion

Elderly diabetics are at a higher risk for developing root caries and are strongly advised to maintain good oral hygiene practices and to undergo periodic dental evaluations. Therefore, it is crucial to emphasize early diagnosis and treatment of root caries in this population.

Prevalence, and Risk Indicators of Coronal and Root Caries in Mexican Older Adults in Nursing Homes

Background

Several factors are associated with coronal and root caries in older persons. The purpose of this study was to determine the experience, prevalence, and risk indicators (socioeconomic, sociodemographic, and dental variables) of coronal and root caries in older persons residing in nursing homes in Mexico.

Methods

A cross-sectional study was carried out in 227 dentate participants with natural teeth. Convenience sample, where all dentate residents were invited to participate. The dependent variables were coronal caries and root caries, which were determined through an oral clinical examination. The independent variables were sociodemographic factors, location, type of center, surfaces free of dental biofilm and calculus, surfaces with recession, retainers in contact with surfaces with recession, xerostomia, smoking, and the previous use of dental services. The binary logistic regression model was used in the analysis.

Results

The mean age of the participants in this study was 77.7±8.8 years, and 69.2% were women. Moreover, 71.8% live in long-term care facilities, and 48.0% live in Mexico City. The prevalence of coronal and root caries was found to be 67.8% and 50.7%, respectively. Being male and living in Mexico City were risk indicators for coronal caries, and with a 1% increase in surfaces with no biofilm, the risk decreased by 2%. Being widowed, having government or no social security, denture retainers, and coronal caries were risk indicators for root caries, while the utilization of dental services indicated lower risk.

Conclusion

Several variables that differ in nature were found to be risk indicators for coronal and root caries. Coronal caries increases the risk of root caries. Prevention should be aimed at identifying persons at higher risk, and dental care should be improved for persons living in long-term care institutions.

Alternative Antibiotics in Dentistry: Antimicrobial Peptides

The rise of antibiotic resistant bacteria due to overuse and misuse of antibiotics in medicine and dentistry is a growing concern. New approaches are needed to combat antibiotic resistant (AR) bacterial infections. There are a number of methods available and in development to address AR infections. Dentists conventionally use chemicals such as chlorohexidine and calcium hydroxide to kill oral bacteria, with many groups recently developing more biocompatible antimicrobial peptides (AMPs) for use in the oral cavity. AMPs are promising candidates in the treatment of (oral) infections. Also known as host defense peptides, AMPs have been isolated from animals across all kingdoms of life and play an integral role in the innate immunity of both prokaryotic and eukaryotic organisms by responding to pathogens. Despite progress over the last four decades, there are only a few AMPs approved for clinical use. This review summarizes an Introduction to Oral Microbiome and Oral Infections, Traditional Antibiotics and Alternatives & Antimicrobial Peptides. There is a focus on cationic AMP characteristics and mechanisms of actions, and an overview of animal-derived natural and synthetic AMPs, as well as observed microbial resistance.

A Systematic Review on Caries Status of Older Adults

The aim of this systematic review was to provide an update on caries prevalence in older adults aged 60 years or above around the globe. Two independent reviewers performed a systematic literature search of English publications from January 2016 to December 2020 using Pubmed, Scopus, Embase/Ovid and Web of Science. The MeSH terms used were “dental caries”, “root caries”, “DMF index”, “aged” and “aged 80 and over”. Further searches in Google Scholar retrieved eight additional publications. The epidemiological surveys reporting the prevalence of dental caries or root caries or caries experience using DMFT (decayed, missing and filled teeth) and DFR (decayed and filled root) in older adults aged 60 years or above were included. Quality of the publications was assessed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. Among the 5271 identified publications, 39 articles of moderate or good quality were included. Twenty studies were conducted in Asia (China, India, Vietnam, Singapore and Turkey), ten in Europe (Ireland, Norway, Finland, Germany, Portugal, Poland, Romania and Kosovo), three in North America (USA and Mexico), one in South America (Brazil), two in Oceania (Australia) and three in Africa (Malawi, Egypt and South Africa). The prevalence of dental caries ranged from 25% (Australia) to 99% (South Africa), while the prevalence of root caries ranged from 8% (Finland) to 74% (Brazil) in community dwellers. The situation was even worse in institutionalised older adults of which the mean DMFT score varied from 6.9 (Malawi) to 29.7 (South Africa). Based on the included studies published in the last 5 years, caries is still prevalent in older adults worldwide and their prevalence varies across countries.